What is the principle of lumbar puncture needle subarachnoid block? Ask the anesthesiologist to answer.

There are three layers of meninges in the spinal cavity: the dura mater, the arachnoid, and the pia mater. The space between the vertebral body periosteum and the dura mater is the epidural space. Between the arachnoid and the pia mater covering the spinal cord is the subarachnoid space. The cerebrospinal fluid and spinal cord are in the subarachnoid space, but the spinal cord below the lumbar 1 segment is scattered into a cauda equina and suspended in the cerebrospinal fluid, so the puncture below the lumbar 1 usually does not damage the nerves. Clinically, the lumbar 2-3 is usually selected. , 3-4 or lumbar 4-5 space for puncture, after the local anesthetic enters the subarachnoid space, according to the position and thickness of the nerve, respectively, the nerve block is performed, the sympathetic nerve is the thinnest, the block is the fastest, and the plane is also the highest. The sensory nerve is second, the block is later, and the plane is higher; the motor nerve is the thickest, the block is the latest, and the plane is the lowest.

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